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The pharmaceutical industry has failed to deliver in countries both rich and poor - for neglected diseases, for antibiotics, and for affordable cures generally. New drug prices can exceed $80,000 annually and productivity in the pharmaceutical industry has been declining exponentially. At the same time, according to the Global Forum for Health Research, less than 10% of global health research is devoted to conditions that account for 90% of all preventable deaths that occur worldwide. The needs of billions are left unmet by an industry ripe for upending. A radical, alternative, end-to-end, open source pharmaceutical system dedicated to breakthroughs in affordable medicine is possible. It would leverage exponential advances in computing power and collaborative technologies, alternative approaches to intellectual property, and the vast reach of the generics industry. We hope to create an alternative, open source pharmaceutical system driven by openness, patient needs, and affordability.